Podcasts about itraconazole

On episode #62 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 8/15/24 – 8/28/24. Host: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Clinician Specialty and HIV PrEP Prescription Reversals and abandonments (JAMA Network: JAMA Internal Medicine) The association between adherence to antiretroviral therapy and viral suppression under dolutegravir-based regimens (JIAS Journal of the International AIDS Society) Dexamethasone in adults with viral meningitis (CMI Clinical Microbiology and Infection) Oropouche Virus Disease Among U.S. Travelers — United States, 2024 (MMWR) Oropouche fever, the mysterious threat (LANCET: Infectious Diseases) Bacterial High rates of Non-susceptibility to common oral antibiotics in Streptococcus pneumoniae clinical isolates (OFID) New York State Department of Health Directs Providers to Discontinue Use of Ciprofloxacin to Prevent Meningococcal Disease Due to Increasing Antimicrobial Resistance (NY State: Department of Health) Tularemia Associated with Harbor Seal Necropsy — Kitsap County, Washington, October 2023 (MMWR) FDA Marketing Authorization Enables Increased Access to First Step of Syphilis Diagnosis (FDA) Clinical impact of pleural fluid Streptococcus pneumoniae PCR testing in children with complicated pneumonia (CID) The Role of the Gut, Urine and Vaginal Microbiome on the Pathogenesis of Urinary Tract Infection (OFID) Fungal The Last of US Season 2 (YouTube) Two dose levels of once-weekly fosravuconazole versus daily itraconazole in combination with surgery in patients with eumycetoma in Sudan (LANCET Infectious disease) Parasitic Usefulness of real-time PCR for urogenital schistosomiasis in preschool children in Angola (PLoS Neglected Tropical Diseases) Helminth infection driven gastrointestinal hypermotility alterations in smooth muscle instead of enteric neurons (PLoS Pathogens) Die-off reaction of Demodex mites after treating demodicosis with oral ivermectin (JAAD case reports) Miscellaneous Prevalence of carbapenem-resistant gram negative bacteria among neonates suspected for sepsis in Africa (BMC Infectious Diseases) New era of targeted clinical guidelines: IDSA (CID) Defining the landscape of educational experiences in transplant infectious diseases (OFID) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

Dr. John Kim's journey from surviving a widow-maker heart attack at 33 to becoming a leading functional medicine pharmacist is nothing short of remarkable. In this episode, we explore mold toxicity and its connection to chronic illnesses like SIBO and autoimmune diseases through Dr. Kim's powerful personal story.We delve into managing SIBO in mold-exposed environments, discussing practical treatments like itraconazole and nasal irrigation. Dr. Kim shares invaluable insights from his tele-wellness practice on optimizing hormonal balance, addressing immune dysfunction, and restoring gut health. We also highlight the effects of mycotoxins on DNA expression and the importance of healthy cell membranes for detoxification.Our conversation dispels myths about quick detox solutions, emphasizing a holistic approach. Dr. Kim offers advice on proper enzyme supplementation and the benefits of spore-based probiotics for digestive health. We conclude with the essential mindset for a vibrant life and where to find more resources and connect with Dr. Kim. Don't miss this in-depth look at mold's impact on well-being. Chapters:(00:00) Mold Toxicity & Chronic Illness Causes(15:43) Mold Toxicity and Environmental Exposure(30:47) Cellular Detox and Mold Toxicity DNA(41:22) Cellular Detox and Mold Prevention(49:14) Cellular Detox and Toxin Accumulation(53:08) Optimizing Detox and Gut Health Links:www.drkimwellness.comJoin Over 18,000 Leading Medical Professionals and Become a Vibrant Wellness Provider Today! (https://portal.vibrant-wellness.com/#/sign-up)

Episode 62: Onychomycosis (nail fungus). Future doctors Gabrielle and Jeanette discuss with Dr Arreaza the diagnosis and treatment of onychomycosis, AKA nail fungus.By Gabrielle Robinson, MS3, and Jeanette Adereti, MS3Ross University School of MedicineFacilitated by Hector Arreaza, MDThis is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home.What is onychomycosis?-Onychomycosis is a fungal infection that resides in the finger and toenails. The nails become discolored, have onycholysis (painless separation of nail bed), splitting of nail bed, thickened. There are various causes of onychomycosis and examples include the following: dermatophytes, yeast, non-dermatophyte molds.-Onychomycosis occurs in 10% of the general population. Microbiology:Dermatophytes such as Tinea rubrum, account for most onychomycosis infections (~60-70%) while candida account for most of yeast causes of onychomycosis. Non-dermatophyte molds include fusarium, aspergillus, acremonium, scytalidium, Scopulariopsis brevicaulis. The type of organism involved has an association for the type of infection it causes. Yeast infects fingernails preferentially while the dermatophytes prefer to infect toenails. Diagnostic testing including culture, KOH preparation and PAS staining can help with confirming fungal infection, but culture not required for empiric treatment with oral terbinafine. Severity of onychomycosis:-Mild-moderate: ≤50 percent involvement of the nail and sparing the matrix/lunula-Moderate-severe: involving >50 percent of the nail or involving the matrix or lunula, including further spread throughout nail.-It's common to have multiple nails affected at the same time. Toenails and fingernails can both be affected. Remember to check all nails in your patients. Nails can show signs of local but also systemic diseases. Risk factors:-Health conditions: Diabetes, immune suppression, venous insufficiency, peripheral artery disease, or even just having slow growth of the nails. This makes sense because there is decreased blood flow to those areas resulting in decreased immune surveillance of that area. Patient s with PAD are at risk for onychomycosis. Nails normally grow slower in male. Hormones play a role in that growth.-Exposure: smoking, trauma to the nail, sports, wearing sweaty shoes, being barefoot in communal areas such as swimming pools, college showers, jail house showers, and gyms.-Dermatological diseases: tinea pedis (athletes' foot), excessively sweaty hands (hyperhidrosis), psoriasis-Other factors: old age, having family members whom the patient shares a living space with, bunion (hallux valgus). Effects on mental healthUnfortunately, the infection takes a toll on the patient because the infection is unsightly it results in psychosocial disturbances. The patients may not want to wear sandals, get pedicures, or shower during gym class if they are school age. These types of feelings can cause patients to not want to go to work or do things they enjoy due to feelings of embarrassment. ManagementTreatment of dermatophyte onychomycosis is guided by causative organism, severity, treatment availability, and cost.Oral agents-Oral treatment is generally the gold-standard for onychomycosis due to shorter course and greater efficacy compared to topical. -Oral terbinafine is the preferred oral agent. Itraconazole can be used in patients not able to tolerate/respond to terbinafine.-Terbinafine and itraconazole both work by blocking important enzymes in fungal synthesis.-A randomized double-blind trial showed that terbinafine is more effective outcomes and better long-term cure rates than itraconazole.-Adult dosing of terbinafine: fingernail onychomycosis =250 mg per day for 6 weeks. Toenail onychomycosis= 250 mg per day for 12 weeks.-Some side effects of oral terbinafine include headache, dermatitis, GI distress, taste disturbances, and liver enzyme abnormalities. Adverse effects of Itraconazole include headache, GI disturbances, liver enzyme abnormalities.-In patients receiving continuous therapy, monitoring of transaminase levels is typically performed at baseline and repeated at six weeks if therapy will continue beyond six weeks. A medication interaction check is recommended before starting treatment with oral agents. -Mycotic cure rates of 76% for terbinafine, 63% for itraconazole with pulse dosing, 59% for itraconazole with continuous dosing, and 48% for fluconazole, topical cure rate is about 40%.-Recurrence of infection ranges 10-50% (reinfection or persistent infection). Patients need to wait for up to 1 year to see full effect of treatment. Treatment is highly recommended in patients with diabetes, treatment in other patients is cosmetic.CompliancePatient compliance is difficult because while taking oral medications, you cannot drink alcohol, and this becomes a problem due to the length of the treatment.Topical agents-Efinaconazole, Amorolfine, Tavaborole, Ciclopirox-Patients who have contraindications to systemic antifungal therapy, who are at risk for drug-drug interactions with systemic antifungal drugs, or who prefer to avoid systemic treatment can be treated with topical therapy. Similarly, to oral agents, these medications work by blocking important processes in fungal synthesis. These agents come in solutions or nail lacquer. Possible side effects include local skin irritation or ingrown nails.Alternatives-Less common therapeutic interventions for onychomycosis include oral antifungal agents other than terbinafine and itraconazole, laser therapy, photodynamic therapy, and surgical nail removal.-Patients with pain or discomfort from infected nails may benefit from removal of hyperkeratotic nail debris. Application of topical urea under occlusion can help with debridement of the nail and symptom improvement.-Recurrence after treatment of onychomycosis is common.Prevention:Now that we have gone over a lot of material about onychomycosis, we should discuss how we can prevent these types of infections from occurring.  Having good “foot hygiene” can help reduce the of infection and re-infection.Wash your hands and feet frequently, especially after encountering someone who is infected.  Clip nails straight across and file afterward making sure to sterilize clippers before and after each use.  Do not share nail clippers with others.If you have a history of sweaty feet, consider using sweat absorbing socks or wearing “breathable shoes” to prevent sweat from accumulating.Throw out old shoes or disinfect them using antifungal powders.Wear sandals in communal shower areas and at the pool.Pay attention to the cleanliness of your nail salon.Joke: Do you want to know how a person with toenail fungus feels? Just step into their shoes.Conclusion: Now we conclude our episode number 62 “Onychomycosis (nail fungus).” Future doctors Robinson and Adereti gave a very good summary about symptoms, diagnosis, and treatment of this common infection. Remember, not all patients need to be treated, but patients with diabetes or other risks are highly encouraged to receive treatment to prevent future complications. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Gabrielle Robinson, and Jeanette Adereti. Audio edition: Suraj Amrutia. See you next week!__________________________References: Goldstein, Adam O et al, Onychomycosis: Epidemiology, clinical features, and diagnosis, Up to Date, last updated: Apr 30, 2019. https://www.uptodate.com/contents/onychomycosis-epidemiology-clinical-features-and-diagnosis?search=onychomycosis&source=search_result&selectedTitle=2~92&usage_type=default&display_rank=2. Bai, Jennifer, MD, Consult Corner: Laceration through the nail bed, American Society of Plastic Surgeons, January 1, 2020. https://www.plasticsurgery.org/for-medical-professionals/publications/plastic-surgery-resident/news/consult-corner-laceration-through-the-nail-bed. Goldstein, Adam O et al, Onychomycosis: Management, Up to Date, last updated: Nov 20, 2020. https://www.uptodate.com/contents/onychomycosis-management?search=onychomycosis&source=search_result&selectedTitle=1~92&usage_type=default&display_rank=1. Rodgers P, Bassler M. Treating onychomycosis. Am Fam Physician. 2001 Feb 15;63(4):663-72, 677-8. Erratum in: Am Fam Physician 2001 Jun 1;63(11):2129. PMID: 11237081. https://www.aafp.org/afp/2001/0215/p663.html. Mayo Clinic, Patient and Health Information, Nail Fungus, https://www.mayoclinic.org/diseases-conditions/nail-fungus/symptoms-causes/syc-20353294

Dr. Ebell and Dr. Wilkes discuss the POEM titled ' Terbinafine and itraconazole are most effective for toenail onychomycosis '

Tinea pedis (commonly known as athlete's foot) is an acute or chronic dermatosis. Most infections are caused by the Trichophyton species. The patient will present with itching, burning, or stinging. Pain here may indicate secondary infection with complicating cellulitis. Interdigital tinea pedis is the most common predisposing cause of lower extremity cellulitis in healthy individuals. On the sole and heel, tinea may appear as chronic noninflammatory scaling occasionally with thickening or fissuring. This may extend over the sides of the feet in a moccasin distribution. The KOH preparation is usually positive. Tinea pedis can also present as scaling or fissuring in the toe webs with maceration. As the web spaces become more macerated, the KOH preparation and fungal culture have a lower tendency to return positive results because bacterial species begin to dominate. The malady can be treated with aluminum subacetate solution soaks for 20 minutes twice daily. Broad spectrum antifungal creams and solutions will help combat dipheriods and other gram-positive organisms. If topical imidazoles fail, one week of topical allylamine treatment will often result in clearing. Itraconazole (200 mg daily for two weeks or 400 mg daily for one week) can be used in refractory cases. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

In today's VETgirl online veterinary continuing education podcast, we review the use of compounded itraconazole in cats - can you use it?

In today's VETgirl online veterinary continuing education podcast, we review the use of compounded itraconazole in cats - can you use it?

Interview with Professor Matthew Fisher (Imperial University, London) about his research on the fungus Batrachochytrium dendrobatidis that causes the often lethal disease, Chytridiomycosis in amphibians. UAR interviewed Prof Matthew Fisher of Imperial University London about his work on the fungus, Batrachochytrium dendrobatidis (Bd) currently devastating amphibian species around the world. Matthew and his team have been the first to successfully treat infected frogs and their tadpoles. They 'cured' individual midwife toads (Alytes obstetricans) with a dilute solution of a fungicide Itraconazole and after cleaning their habitat in the mountains of Majorca were able to re-introduce the species where they had previously become locally extinct. This is the first time amphibians have been successfully re-introduced following an outbreak of Batrachochytrium dendrobatidis. While this method is not an answer to removing the fungus from the wider environment it does make it possible for people to remove threatened species into captivity and maintain them in 'arks' until their descendants can be returned to the wild. Read more here: http://www.britannica.com/topic/Bd-The-Amphibian-Plague-2037002 Download a transcript of the interview here. References Bosch J, Sanchez-Tomé E, Fernández-Loras A, Oliver JA, Fisher MC, Garner TWJ. (2015) Successful elimination of a lethal wildlife infectious disease in nature. Biology Letters. DOI: 10.1098/rsbl.2015.0874 Fisher MC, Henk DA, Briggs C, Brownstein JS, Madoff L, McCraw SL, Gurr S. (2012) Emerging fungal threats to animal, plant and ecosystem health. Nature 484: 186-194

Management of Onychomycosis in Canada in 2014 http://www.ncbi.nlm.nih.gov/pubmed/25775640 Drug name: Brand: SA SA Criteria SA Approval period Direction SE Monitoring Ciclopirox 8% Penlac (nail lacquer) No Not covered N/A Nail lacquer: Apply bid to adjacent skin and affected nails daily. Remove with alcohol every 7 days (treat 4 weeks) dermatitis, dry skin, local burning sensation Efinaconazole […] The post Onychomycosis appeared first on Family Pharm Podcast.

May 19, 2011 Discussion of the role of hedgehog signaling and repositioning of drugs for pediatric cancers such as anti-fungal drug itraconazole In this fifth episode, hosts Dr. Tim Cripe and Dr. Maureen O'Brien discuss the role of targeting of hedgehog signaling in diffuse intrinsic pontine glioma (DIPG) and the use of drugs designed for other uses -- designed for other uses -- such as itraconazole, an anti-fungal drug found to suppress hedgehog signaling -- as a possible treatment for medulloblastoma. 1:20 feedback and comments on previous TWiPO episode 2:58 Hedgehog-responsive candidate cell of origin for diffuse intrinsic pontine glioma; (fulltext) Proc Natl Acad Sci U S A. 2011 March 15; 108(11): 4453–4458 9:22 Itraconazole, a commonly used antifungal that inhibits Hedgehog pathway activity and cancer growth. Cancer Cell. 2010 Apr 13;17(4):388-99.

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In this paper a method for the simultaneous quantification of the anti-fungal drug itraconazole and its co-active metabolite hydroxyitraconazole in plasma employing liquid chromatography tandem-mass spectrometry and automated solid-phase extraction is described. The method proved rugged, enables short turn-around times and is highly specific. Since there is growing evidence for the importance of therapeutic drug monitoring of itraconazole in the prophylaxis and treatment of invasive fungal infections, the method described here is of interest for a large number of tertiary care hospital laboratories.